overactive bladder
| ICD-10 | N32.8 |
|---|---|
| ICD-9 | 596.51 |
Overactive bladder (OAB) is a urological condition defined by a set of symptoms: "urgency, with or without urge incontinence, usually with frequency and nocturia." The International Continence Society (ICS) is responsible for this definition. There exists, however, controversy over the use of this term because it also describes other bladder conditions with similar symptoms, including interstitial cystitis. The original definition of OAB was focused, primarily, on incontinence. However, some have suggested that patients with frequency/urgency without incontinence be labeled as OAB patients when those symptoms may also reflect the presence of interstitial cystitis in the bladder. Indeed, many urologists consider OAB a mild form of interstitial cystitis. In late 2006, the debate over nomenclature became even more unclear with the proposal by the ESSIC society to rename interstitial cystitis as bladder pain syndrome.
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Earlier reports estimated that about one in six adults in the United States or Europe had OAB.[1][2] Because the average age of people in the developed world is increasing, it is expected that OAB will become more common in the future as the prevalence of OAB increases with age.[1][2] However, a recent Finnish population-based survey[3] showed that the prevalence had been largely overestimated due to methodological shortcomings regarding age distribution and low participation (in earlier reports). OAB affects approximately half of that proposed earlier.[3]
Treatment for OAB includes lifestyle modification (fluid restriction, avoidance of caffeine), bladder retraining, antimuscarinic drugs (darifenacin, hyoscyamine, oxybutynin, tolterodine, solifenacin, trospium), and various devices (Urgent PC Neuromodulation System, InterStim). Intravesical botulinum toxin A is also used in some intractable cases, although not with formal FDA approval. The antimuscarinic fesoterodine was recommended for approval by the European Medicines Agency in February 2007, but is not yet available for use.
References
- ^ a b Stewart WF, Van Rooyen JB, Cundiff GW, Abrams P, Herzog AR, Corey R, Hunt TL, Wein AJ. Prevalence and burden of overactive bladder in the United States World Journal of Urology 2003 May;20(6):327-36..
- ^ a b Milsom I, Abrams P, Cardozo L, Roberts RG, Thuroff J, Wein AJ. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int. 2001 Jun;87(9):760-6.
- ^ a b Tikkinen KAO, Tammela TLJ, Rissanen AM, Valpas A, Huhtala H, Auvinen A. Is the Prevalence of Overactive Bladder Overestimated? A Population-Based Study in Finland PLoS ONE 2007 2(2):e195..
Support Resources
- Interstitial Cystitis Network
- Cystitis & Overactive Bladder Foundation - UK
- Canada IC & OAB Resource Center
- 2006 IC & PBS On-Line Patient Conference
Information Resources
- IC Patient Handbook
- IC Top Five List of Forbidden Foods
- Overcoming Overactive Bladder
- Interstitial Cystitis Survival Guide
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